International journal of clinical and experimental medicine
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Both target radiofrequency thermocoagulation and collagenase chemonucleolysis are effective micro-invasive therapy means for lumbar intervertebral disc herniation. In order to analyze the clinical effects of target radiofrequency thermocoagulation combined with collagenase chemonucleolysis on lumbar intervertebral disc herniation, the contents of hydroxyproline and glycosaminoglycan were measured and the histological changes of nucleus pulposus was detected in the vitro experiments. Radiofrequency thermocoagulation reduced the hydrolyzation of herniated nucleus pulposus caused by collagenase, as well as the content of hydroxyproline and glycosaminoglycan. ⋯ In the post-operative follow-up exam, 86.8% of the re-examined cases demonstrated smaller or ablated protrusion, with reduced IDH values from pre-operation, which was statistically significant. No serious complications were detected intra-operatively and post-operatively. In conclusion, target radiofrequency combined with collagenase chemonucleolysis was an effective and safe method for treatment of lumbar intervertebral disc herniation.
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Acute pulmonary embolism (PE) is potentially a life threatening emergency that needs prompt management to reduce preventable deaths. Symptoms like dyspnoea and chest discomfort often lack specificity and overlap with acute coronary syndrome (ACS). Importantly, electrocardiographic changes associated with PE are reported to be variable with some ECG patterns mimicking ACS, posing problems in the differential diagnosis. ⋯ However, this ECG change is more likely to present in ACS. We herein reported a case of a 78-year-old man presenting with progressive shortness of breath on exertion secondary to submassive pulmonary embolism which was initially misdiagnosed as ACS due to diffuse T wave inversion in both precordial leads V1-6 and inferior Leads II, III and aVF. Here, we discussed the diagnosis of this case and reviewed the medical literature with an emphasis on the limitations of ECG for the differentiation between PE and ACS.
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This study is to investigate the predictive factors of blood loss in ankylosing spondylitis (AS) patients. Retrospective analysis was performed in patients with thoracolumbar kyphotic deformity secondary to ankylosing spondylitis who underwent PSO from 2008 through 2013. Patient's demographics, preoperative and postsurgical global kyphosis (GK) angle, preoperative hematologic tests and other factors related to PSO were analyzed. ⋯ Multiple stepwise analysis identified male sex (P = 0.000), and two-level osteotomy (P = 0.016) to be predictive factors of increased EBL/EBV percentage in AS patients undergoing PSO for thoracolumbar kyphosis. Male and two-level osteotomy are the two most significant factors predicting increased EBL/EBV percentage in AS patients undergoing PSO for thoracolumbar kyphosis. These predictors can provide more adequate preoperative preparations.
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Case Reports
Serious anaphylactic shock induced by hemocoagulase agkistrodon during anesthesia in a 5-year-old child.
We report a case of serious anaphylactic shock in a 5-year-old child undergoing scheduled surgery blank space of a right femoral intramedullary nail removal. The boy had undergone right femoral elastic intramedullary nail fixation surgery 14 months prior, but had no history of allergies. Within 5 minutes of intravenous bonus injection of hemocoagulase agkistrodon (HCA) 1 unit, a widespread transient diffuse erythema was seen on the front of his chest. ⋯ Total amount of dexamethasone sodium phosphate 14 mg was used. To the best of our knowledge, few case reports of HCA-induced anaphylactic shock in children exist. Our report will, therefore, increase awareness of the allergic potential of HCA among pediatric anesthesiologists.
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Early post-operative mobilization is important both to reduce immobility-related complications and to get the best functional result following surgery on knee. We hypothesized that saphenous nerve block would reduce pain in this patient category compared with placebo injection. In this study, two reviewers independently searched the databases of PubMed, EMBASE, and Cochrane Library (last performed on 12 October, 2014) to retrieve eligible randomized controlled clinical trials. ⋯ In addition, compared to placebo injection group, saphenous nerve block resulted in significantly less morphine consumption during the first postoperative 24 hours (MD = -6.56; 95% CI -11.26 to -1.86; P = 0.006). To conclude, this meta-analysis suggests that saphenous nerve block has an advantage in pain relief both at an active flexion of knee and at rest after knee surgery. Further studies are still wanted to validate these conclusions.